Artificial intelligence for classification of temporal lobe epilepsy with ROI-level MRI data: A worldwide ENIGMA-Epilepsy study

Artificial intelligence has recently gained popularity across different medical fields to aid in the detection of diseases based on pathology samples or medical imaging findings. Brain magnetic resonance imaging (MRI) is a key assessment tool for patients with temporal lobe epilepsy (TLE). The role of machine learning and artificial intelligence to increase detection of brain abnormalities in TLE remains inconclusive. We used support vector machine (SV) and deep learning (DL) models based on region of interest (ROI-based) structural (n = 336) and diffusion (n = 863) brain MRI data from patients with TLE with (“lesional”) and without (“non-lesional”) radiographic features suggestive of underlying hippocampal sclerosis from the multinational (multi-center) ENIGMA-Epilepsy consortium. Our data showed that models to identify TLE performed better or similar (68–75%) compared to models to lateralize the side of TLE (56–73%, except structural-based) based on diffusion data with the opposite pattern seen for structural data (67–75% to diagnose vs. 83% to lateralize). In other aspects, structural and diffusion-based models showed similar classification accuracies. Our classification models for patients with hippocampal sclerosis were more accurate (68–76%) than models that stratified non-lesional patients (53–62%). Overall, SV and DL models performed similarly with several instances in which SV mildly outperformed DL. We discuss the relative performance of these models with ROI-level data and the implications for future applications of machine learning and artificial intelligence in epilepsy care

The ENIGMA-Epilepsy working group: Mapping disease from large data sets

Epilepsy is a common and serious neurological disorder, with many different constituent conditions characterized by their electro clinical, imaging, and genetic features. MRI has been fundamental in advancing our understanding of brain processes in the epilepsies. Smaller‐scale studies have identified many interesting imaging phenomena, with implications both for understanding pathophysiology and improving clinical care. Through the infrastructure and concepts now well‐established by the ENIGMA Consortium, ENIGMA‐Epilepsy was established to strengthen epilepsy neuroscience by greatly increasing sample sizes, leveraging ideas and methods established in other ENIGMA projects, and generating a body of collaborating scientists and clinicians to drive forward robust research. Here we review published, current, and future projects, that include structural MRI, diffusion tensor imaging (DTI), and resting state functional MRI (rsfMRI), and that employ advanced methods including structural covariance, and event‐based modeling analysis. We explore age of onset‐ and duration‐related features, as well as phenomena‐specific work focusing on particular epilepsy syndromes or phenotypes, multimodal analyses focused on understanding the biology of disease progression, and deep learning approaches. We encourage groups who may be interested in participating to make contact to further grow and develop ENIGMA‐Epilepsy

I know people who can and who cannot: A measure of the perception of economic inequality in everyday life

Versión preprintThis paper describes the development of the Perceived Economic Inequality in Everyday Life (PEIEL) scale. It is written and validated in Spanish. We first carried out an exploratory study, using a sample of 205 participants (52.2% men and 47.8% women; age: M = 24.69, SD = 8.95). We then conducted a confirmatory study with a sample size of 215 individuals (43.7% men and 56.3% women; age: M = 23.83, SD = 6.46). Results showed that the PEIEL scale is a valid and reliable unidimensional instrument. This scale negatively predicted tolerance of economic inequality over and above perceived inequality measured by wage gap estimates. In addition, perceived economic inequality in everyday life was negatively associated with tolerance of inequality, particularly in individuals with right-wing political ideology.Universidad de Costa Rica/[OAICE-006-2017]/UCR/Costa RicaUCR::Sedes Regionales::Sede de Occident

Scientific and Technical Report of the DRAGO 0511 Oceanographic Cruise. Extension of the Spanish Continental Shelf west off Canary Island

Informe científico de la campaña y de los resultados preliminaresLa campaña DRAGO 0511 forma parte de los trabajos para la extensión de la plataforma continental española al oeste de las islas Canarias conforme a la Convención de Naciones Unidas sobre Derecho del Mar (CONVEMAR). Han participado un total de 19 científicos y técnicos, 4 investigadores del Instituto Español de Oceanografía (IEO) y 4 investigadores del Instituto Geológico y Minero de España (IGME) del Ministerio de Ciencia e Innovación, 2 investigadores de TRAGSA (para la Secretaría General del Mar) del Ministerio de Medio Ambiente, Medio Rural y Marino, y 6 hidrógrafos del Instituto Hidrográfico de la Marina (IHM) del Ministerio de Defensa, así como 5 estudiantes (2 de grado y 3 de postgrado) de la Facultad de Ciencias del Mar y Ambientales de la Universidad de Cádiz, y de la Facultad de Ciencias Geológicas (Titulación de Ingeniería Geológica) de la Universidad Complutense. El objetivo de esta campaña es la adquisición de los datos científicos necesarios para preparar la propuesta de ampliación de la plataforma continental española más allá de las 200 millas marinas del área situada al oeste de las Islas Canarias, conforme al artículo 76 de CONVEMAR. La información que se ha obtenido es fundamentalmente de batimetría multihaz y monohaz, perfiles de la velocidad del sonido, perfiles sísmicos de alta resolución, y muestreo de fondos principalmente mediante dragas de roca. Estos datos permitirán definir desde un punto de vista morfográfico, morfosedimentario y geológico, la región de la base del talud, así como llevar a cabo la localización de los posibles pies de talud (FOS) en esta región,y demostrar la estrecha relación existente entre la zona estudiada y el archipiélago de las Islas Canarias. En este sentido se han estudiado de forma preferente un conjunto de montes submarinos presentes al suroeste de las islas Canarias cuya génesis, de origen magmático, se debe encontrar en los mismos procesos de “punto caliente” que probablemente han debido generar los edificios volcánicos que constituyen las propias islas Canarias. Por otro lado, se ha localizado la presencia de grandes cuerpos sedimentarios constituidos por materiales procedentes de estos montes submarinos y generados por movimientos en masa de tipo gravitacional a favor de la pendiente del talud continental. La presencia tanto de estos montes submarinos, como de las grandes masas de sedimentos gravitacionales y, además la localización de escarpes en el talud, serán puntos clave de gran interés en esta región, siendo argumentos científicos válidos para demostrar la prolongación natural del territorio emergido del archipiélago canario así como para localizar los puntos del pie del talud continental. Durante la campaña DRAGO 0511 se han adquirido un total de 10895.4 km de registros con sonda multihaz EM302, sonda monohaz EA 600 y sonda paramétrica TOPAS PS 18. De dichas líneas, 9647.3 km se han realizado en las dos zonas de trabajo planificadas, 5603.2 km en la zona A y 4044.3 km en la zona B. En la zona A se ha cubierto un área total de 19996 km2 mientras que en la zona B la extensión ha sido de 13545 km2. En total se ha cubierto una extensión de 17795 km2 en el área de posible ampliación de la plataforma continental española. Por otra parte, cabe señalar que además 16471 km2 de líneas se han realizado dentro de la ZEE española del archipiélago canario, que se utilizarán, en algún caso, para demostrar la continuidad de estos cuerpos sedimentarios con las islas Canarias, y más adelante para la cartografía de este sector de la ZEE española. El resto de registros, 1151.5 km. corresponden a los tránsitos. En el total del tiempo de la campaña DRAGO 0511, un 70.5 % se ha trabajado sobre las zonas planificadas A y B localizadas sobre las áreas de ampliación de la plataforma continental española o sobre puntos concretos de la ZEE española que pueden ser utilizados para establecer los FOS, un 16.7 % en tránsitos sobre la ZEE española de las islas Canarias y un 7.1% de recalada en los puertos de Santa Cruz de Tenerife y de La Estaca de la Iila de El Hierro. Los datos obtenidos en la campaña DRAGO 0511 serán usados para elaborar la presentación del trazado del límite exterior de la plataforma continental de España más allá de las 200 millas marinas en el polígono del archipiélago de las islas Canarias conforme a la parte VI y el anexo II de CONVEMAR. Dicha presentación de datos e información científica se deberá realizar ante la Comisión de límites de la plataforma continental de la Organización de las Naciones Unidas en Nueva York, de conformidad con la CONVEMAR y con las directrices científico-técnicas de dicha Comisión, con anterioridad al 9 de mayo del año 2014.Ministerio de Asuntos Exteriores y Cooperación (MAEC), Instituto Español de Oceanografía (IEO) e Instituto Geológico y Minero de España (IGME) ambos del Ministerio de Investigación, Ciencia e Industria (MICINN), Instituo Hidrográfico de la Marina (IHM) del Ministerio de Defensa (MDEF) y Secretaria General del Mar del Ministerio de Medio Ambiente, Medio Rural y Marino (MARM). Acción Complementaria del Plan Nacional de I+D+i CTM2010-09496-

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health